Orthopedic Implant And Methods Of Implanting And Removing Same

ABSTRACT

Illustrative embodiments of orthopedic implants and methods for surgically repairing hammertoe are disclosed. According to at least one illustrative embodiment, an orthopedic implant includes a proximal segment comprising a number of spring arms forming an anchored barb at a first end of the implant, a distal segment extending between the proximal segment and a second end of the implant, and a central segment disposed between the proximal and distal segment.

CROSS-REFERENCE TO RELATED APPLICATION

The present application is a continuation of U.S. patent applicationSer. No. 16/891,732, filed on Jun. 3, 2020 which is a divisional of U.S.patent application Ser. No. 15/669,370, filed on Aug. 4, 2017, which isa divisional of U.S. patent application Ser. No. 14/637,032 (now U.S.Pat. No. 9,757,168) filed Mar. 3, 2015, the disclosures of which areincorporated herein by reference.

TECHNICAL FIELD

The present disclosure relates generally to orthopedic implants. Moreparticularly, the present disclosure relates to orthopedic implants forsurgically repairing joints and methods of implanting and removing same.

BACKGROUND OF THE INVENTION

A hammertoe is condition in which the proximal interphalangeal joints ofthe second, third, fourth, or fifth toe has become deformed, therebycausing the toe to be permanently bent. Hammertoe occurs from a muscleand ligament imbalance around the joints between the toes, which causesthe joints to bend and become stuck in a bent position. Hammertoeoftentimes causes painful rubbing and irritation on the top of the benttoe. If caring for any callouses or corns, changing ones footwear,and/or utilizing cushions, supports, or comfort devices in ones shoes donot alleviate the pain associate with hammertoe, surgical interventionmay be required to alleviate the pain. A procedure may be utilized toanatomically correct the joint using a pin, screw, or other implant.After anatomical correction, fusion or bony consolidation of the jointarea occurs.

SUMMARY OF THE INVENTION

The present application discloses one or more of the features recited inthe appended claims and/or the following features which alone or in anycombination, may comprise patentable subject matter.

According to a first aspect of the present disclosure, an orthopedicimplant may include a proximal segment comprising at least three springarms forming an anchored barb at a first end of the implant, whereinfirst threading extends around outer surfaces of at least a portion ofeach spring arm and the first threading includes minor and majordiameters. The surgical implant may further include a distal segmentextending between the proximal segment and a second end of the implantand including second threading extending along at least a portion of thedistal segment.

In some embodiments, at least two of the major diameters of the firstthreading may increase between the distal segment and the first end ofthe implant.

In some embodiments, each of the major diameters of the first threadingmay increase between the distal segment and the first end of theimplant.

In some embodiments, the proximal segment may be configured to beimplanted within a proximal phalanx of a patient and the distal segmentmay be configured to be threaded into a middle phalanx of the patient.

In some embodiments, the surgical implant may include a marking disposedon the surgical implant between the proximal and distal segments,wherein the marking may be configured to identify an optimal depth forimplantation of the distal segment of the implant into a middle phalanxof a patient.

In some embodiments, the implant may be manufactured ofpolyetheretherketone (PEEK).

In some embodiments, the second threading may include minor diametersand major diameters and at least two of the minor diameters may increasebetween the second end and the proximal segment.

In some embodiments, each of the minor diameters of the second threadingmay increase between the second end and the proximal segment.

In some embodiments, the proximal segment may include a drive featureformed in an end thereof that is configured to accept a tool for removalof the implant from a phalanx.

According to a second aspect of the present disclosure, an orthopedicimplant may include a proximal segment comprising at least two springarms forming an anchored barb at a first end of the implant, whereinfirst threading may extend around outer surfaces of at least a portionof each spring arm and the first threading may include minor and majordiameters. The surgical implant may further include a distal segmentextending between the proximal segment and a second end of the implantand include second threading extending along at least a portion of thedistal segment, wherein the second threading may include minor and majordiameters and at least two of the minor diameters may increase betweenthe second end and the proximal segment.

In some embodiments, each of the minor diameters of the second threadingof the distal segment may increase between the second end and theproximal segment.

In some embodiments, each of the major diameters of the first threadingof the proximal segment may increase between the distal segment and thefirst end of the implant.

In some embodiments, the proximal segment may be configured to beimplanted within a proximal phalanx of a patient and the distal segmentmay be configured to be threaded into a middle phalanx of the patient.

In some embodiments, a marking may be disposed on the surgical implantbetween the proximal and distal segments, wherein the marking may beconfigured to identify an optimal depth for implantation of the distalsegment of the implant into a middle phalanx of a patient.

In some embodiments, the implant may be manufactured ofpolyetheretherketone (PEEK).

In some embodiments, the proximal segment may include at least threespring arms forming the anchored barb at the first end of the implant.

In some embodiments, the proximal segment may include a drive featureformed in an end thereof that is configured to accept a tool for removalof the implant from a phalanx.

According to a third aspect of the present disclosure, a method ofremoving an orthopedic implant from a patient may include the step ofsevering an orthopedic implant in a central segment of the orthopedicimplant that is disposed between a proximal segment configured forimplantation within a proximal phalanx of the patient and a distalsegment opposite the proximal segment and configured for implantationwithin a middle phalanx of the patient. The method may further includethe steps of inserting a tool into the proximal or distal segment of theorthopedic implant and rotating the tool to remove the proximal ordistal segment from the proximal or middle phalanx, respectively.

In some embodiments, the method may include one or more of the steps ofsevering the implant, inserting the tool, which is made of ahigh-strength stainless steel, into the distal segment, which is made ofa polymeric material, to thereby tap the tool into the distal segment,and removing the distal segment from the middle phalanx.

In some embodiments, the method may include one or more of the steps ofinserting the tool into an end of the proximal segment, mating a portionof the tool with a drive feature in the proximal segment of the implant,and rotating the tool to remove at least a portion of the surgicalimplant.

In some embodiments, the drive feature may include a plurality ofsemi-cylindrical channels.

According to a fourth aspect, a tool for implantation of an orthopedicimplant having a proximal segment with at least three arms spaced fromone another by recesses, the three arms configured for implantation witha proximal phalanx of a patient and a distal segment opposite theproximal segment and configured for implantation within a middle phalanxof the patient is disclosed. The implantation tool may include a bodyand at least three arms extending from an end of the body, wherein eachof the arms is sized and shaped to fit within one of the recessesdisposed between the three arms in the proximal segment of the implant.

In some embodiments, the arms may have an outer diameter that is lessthan an outer diameter of the arms of the proximal segment of theimplant.

In some embodiments, the tool may be configured to retain the proximalsegment of the implant on the end of the body.

BRIEF DESCRIPTION OF THE DRAWINGS

The concepts described in the present disclosure are illustrated by wayof example and not by way of limitation in the accompanying figures. Forsimplicity and clarity of illustration, elements illustrated in thefigures are not necessarily drawn to scale. For example, the dimensionsof some elements may be exaggerated relative to other elements forclarity. Further, where considered appropriate, the same or similarreference labels have been repeated among the figures to indicatecorresponding or analogous elements.

FIG. 1 is an isometric view of a first embodiment of an orthopedicimplant taken generally from a first end of the implant;

FIG. 2 is an elevational view of a first side of the implant of FIG. 1 ;

FIG. 3 is an elevational view of a second side of the implant of FIG. 1, wherein the second side is opposite the first side depicted in FIG. 2;

FIG. 4 is an elevational view of the first end of the implant of FIG. 1;

FIG. 5 is a cross-sectional view of the implant of FIG. 1 takengenerally along the lines 5-5 of FIG. 4 ;

FIG. 6 is an isometric view of a second embodiment of an orthopedicimplant taken generally from a first end of the implant;

FIG. 7 is an elevational view of a first side of the implant of FIG. 6 ;

FIG. 8 is an elevational view of a second side of the implant of FIG. 6, wherein the second side is opposite the first side depicted in FIG. 7;

FIG. 9 is an elevational view of the first end of the implant of FIG. 6;

FIG. 10 is an elevational view of a second end of the implant of FIG. 7, wherein the second end is opposite the first end;

FIG. 11 is a cross-sectional view of the implant of FIG. 6 takengenerally along the lines 11-11 of FIG. 9 ;

FIG. 12 is a view depicting a tap advanced over a distal Kirschner wire(K-wire) into a middle phalanx of a patient during a first method ofimplantation of an orthopedic implant disclosed herein;

FIG. 13 is a view depicting a proximal K-wire inserted into a center ofa proximal phalanx of a patient and a drill advanced over the K-wireduring the first method of implantation of an orthopedic implant;

FIG. 14A is a view depicting a second end of a distal segment of anorthopedic implant threaded into the middle phalanx of a patient duringthe first method of implantation of an orthopedic implant utilizing animplantation tool;

FIG. 14B is a perspective view of a drive end of the implantation toolshown in use in FIG. 14A, wherein the implantation tool is utilized tothread the distal segment of the orthopedic implant into the middlephalanx;

FIG. 15 is a view depicting insertion of a barbed anchor disposed at afirst end of a proximal segment of an orthopedic implant into apre-drilled hole in the proximal phalanx of the patient during the firstmethod of implantation of an orthopedic implant;

FIG. 16 is a view depicting a method of removing a distal segment of anorthopedic implant in which a threaded tool is utilized to tap an innersurface of the distal segment;

FIG. 17 is a view depicting a method of removing an orthopedic implantin which a tool having a drive features is utilized in combination witha complementary drive feature within a proximal segment of an orthopedicimplant to remove the implant; and

FIGS. 18A and 18B are views depicting bending axes for orthopedicimplants having two and three arms, respectively.

DETAILED DESCRIPTION

While the concepts of the present disclosure are susceptible to variousmodifications and alternative forms, specific exemplary embodimentsthereof have been shown by way of example in the figures and will hereinbe described in detail. It should be understood, however, that there isno intent to limit the concepts of the present disclosure to theparticular forms disclosed, but on the contrary, the intention is tocover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the present disclosure.

A first embodiment of an orthopedic implant 20 suitable for treatmentand correction of hammertoe is depicted in FIGS. 1-5 . The implant 20generally includes a pin-shaped body 22 extending along a longitudinalaxis 24 and further includes a proximal segment 26 terminating in afirst end 28 and a distal segment 30 terminating in a second end 32. Theproximal and distal segments 26, 30 may be integral with one another andjoined at a central, narrowed segment 34 of the implant 20. The proximalsegment 26 of the body 22 may generally comprise the central, narrowedsegment 34 and three spring arms 36 that form a barbed anchor 38 andwhich extend away from the central, narrowed segment 34. While thesegment 34 is depicted as being narrowed, the segment 34 mayalternatively not be narrowed or may have a constant outer diameter.

As seen in FIGS. 1, 2, and 4 , each of the arms 36 is separated fromadjacent arms 36 by a channel 40. Helical threading 41 may be disposedabout outer edges or surfaces 42 of each of the arms 36 and may continuebetween arms 36 (despite the existence of channels 40 therebetween).Each of the arms 36 is formed by opposing side edges 44 that, with sideedges 44 of adjacent arms 36, form the channels 40. As seen in FIGS. 2and 6 , each side edge 44 is formed of a straight segment 46 that isgenerally parallel to a longitudinal axis 24 of the implant 20 and atapered segment 50 that tapers outwardly from the straight segment 46 atan angle A1 of greater than 0 degrees to a tip forming a flattened edge54. In an illustrative embodiment, the angle A1 may be between about 1degree and about 15 degrees. In another illustrative embodiment, theangel A1 may be between about 3 degrees and about 10 degrees. In afurther illustrative embodiment, the angel A1 may be about 7 degrees. Asseen in FIG. 4 , each arm 36 further includes a generally cylindricalinner edge 56 (FIG. 4 ) that tapers outwardly from an inner, generallycylindrical surface 57 of the proximal segment 26. The tapered segment50 and the inner edge 56 are tapered to thin out the arms 36 to providea desired stiffness and even stress distribution for each of the arms36.

The use of three arms 36 provides more resistance to bending of the arms36 along various axes that are perpendicular to the longitudinal axis24. Less bending equates to higher contact forces and improved fixation.Three arms 36 also stabilize the bone in which implantation occurs morethan two arms, since two arms leave a weak bending axis.

Currently, a number of hammertoe implant designs incorporate two springarms for retention in the proximal phalanx, the middle phalanx, or both.Designs with two arms are intrinsically easier to manufacture throughmachining and may be easier to insert into the bone, as well. It hasbeen discovered in the present invention that designs with multiplearms, for example, those with an odd number of arms, impart a strongadvantage to implant fixation in the bone. Implant fixation into thebone is a common failure mode because bone in older hammertoe patientsis oftentimes osteopenic and poorly supports an interface with theimplant. The key to implant stability is the ability of the implant touniformly impart stresses to the underlying bone. The loading vector fora hammertoe implant is predominantly in the dorsal-plantar direction asthe foot moves through the gait cycle, however, complex tri-axialstresses also occur in all planes as the foot pushes laterally or movesover uneven surfaces. The objective of the implant designer should be tocreate a design that retains strength and fixation even in a tri-axialstress state.

A two-arm implant design, as seen in FIG. 18A, has a weak bending axis55 a on a plane of symmetry between the two arms. This weak axis 55 aimparts a deficiency to the design in resisting tri-axial stresses,particularly when the dorsal-plantar loading vector is alignedperpendicularly to a vector of the arm spring force 59 a. In this case,the spring arms contribute little to the stability of the implant in thebone.

As seen in FIG. 18B, a three-arm implant design still has weak bendingaxis 55 b, but the weak bending axis 55 b is not as weak as the weakbending axis 55 a of the two-arm design since there are now arms at moreangular positions along a diameter of the implant. Even if a weak axis55 b of the implant is aligned with the dorsal-plantar loading vector,there are portions of the adjacent spring arms that directly contributeto resistance on the loading vector. This advantage is shared by all armdesigns having three or more arms, although odd-numbered arm designsconvey a particular evenness between the strong and weak axes.Additionally, with odd-numbered arm designs, the dorsal-plantar loadingvector is not aligned perpendicularly to the vector of the arms springforce 59 b. An additional advantage of a three-arm design is that itself-centers in a center of a hole in the bone in which it is implanted.

Referring to FIG. 6 , the inner surface 57 of the proximal segment 26has an inner diameter 58 that does not vary along a first section 62that includes both the central, narrowed segment 34 and a portion of thearms 36. The inner surface 58 further includes a second section 64 thatincludes the generally cylindrical surface 57 of the arms 36 and whichhas a diameter 65 that increases along the longitudinal axis 24 from thecentral segment 34 toward the first end 28. The arms 36, as seen in FIG.6 , include outer edges 42 that, due to the helical threading 41, haveminor diameters 66 a-66 e and major diameters 68 a-68 e. The minordiameters 66 a-66 e of the helical threading 41 may be constant in thatthe diameters thereof do not vary along a length of the threading 41.The major diameters 68 a-68 e of the helical threading 41 may increasefrom a first major diameter 68 a closest the central segment 34 towardthe first end 28 of the proximal segment 30. More particularly, a majordiameter 68 a of the threading 41 may be smaller than each of the othermajor diameters 68 b-68 e and the major diameters 68 b-68 e may eachincrease between the central segment 34 and the first end 28. Anincreasing major diameter 68 a-68 e maximizes bony contact duringinsertion of the second end 28 of the implant 20 into a proximalphalanx, as discussed in more detail below. In other illustrativeembodiments, two or more consecutive or non-consecutive major diameters68 a-68 e may be increasing between the major diameter 68 a and themajor diameter 68 e and/or two or more consecutive or non-consecutivemajor diameters 68 a-68 e may be the same.

Referring again to FIG. 6 , the distal segment 30 includes an innercylindrical surface 80 having an inner diameter 82. The inner diameter82 may be the same or different than the inner diameter 58 of theproximal segment 26. Helical threading 84 may be disposed on an outersurface 86 of all or a portion of the distal segment 30. As seen in FIG.6 , the helical threading 84 includes minor diameters 88 a-88 e andmajor diameters 92 a-92 e, wherein the minor diameters 88 a-88 e mayincrease along the longitudinal axis 24 of the implant 20 between thesecond end 32 and the first end 28. More particularly, a minor diameter88 a of the threading 84 may be smaller than each of the other minordiameters 88 b-88 e and the minor diameters 88 a-88 e may increasebetween minor diameter 88 a and minor diameter 88 e. Increasing minordiameters 88 a-88 e provide tactile feedback when implanting the distalsegment 30 of the implant 20 into a middle phalanx, as discussed ingreater detail below. In alternative illustrative embodiments, two ormore consecutive or non-consecutive minor diameters 88 a-88 e mayincrease between minor diameter 88 a and minor diameter 88 e and/or twoor more consecutive or non-consecutive minor diameters 88 a-88 e may besame. Major diameters 92 a-92 e of the helical threading 84 may increasein diameter from the major diameter 92 a to the major diameter 92 e orthe major diameters 92 a-92 e may be the same. Still alternatively, twoor more consecutive or non-consecutive major diameters 92 a-92 e may beincreasing between the major diameters 92 a and the major diameter 92 eand/or two or more consecutive or non-consecutive major diameters 92a-92 e may be the same.

While a particular number of threads are depicted for the threading 41and 84, any number of threads may be present depending on a particularapplication for the implant 20.

A second embodiment of an orthopedic implant 220 suitable for treatmentand correction of hammertoe is depicted in FIGS. 6-11 . The implant 220generally includes a pin-shaped body 222 extending along a longitudinalaxis 224 and further includes a proximal segment 226 terminating in afirst end 228 and a distal segment 230 terminating in a second end 232.The proximal and distal segments 226, 230 may be integral with oneanother and joined at a central, cylindrical flattened segment 234 ofthe implant 220. The proximal segment 226 of the body 222 may generallycomprise the central flattened segment 234 and three arms 236 that forma barbed anchor 238 and which extend away from the central, flattenedsegment 234.

As seen in FIGS. 5, 6, 7, and 9 , each of the arms 236 is separated fromadjacent arms 236 by a channel 240. Helical threading 241 may bedisposed about outer edges or surfaces 242 of each of the arms 236 andmay continue between arms 236 (despite the existence of channels 240therebetween). Each of the arms 236 is formed by opposing side edges 244that, with side edges 244 of adjacent arms 236, form the channels 240.As seen in FIGS. 7 and 12 , each side edge 244 tapers outwardly at anangle A2 of greater than 0 degrees to a tip forming a flattened edge254. In an illustrative embodiment, the angle A2 may be between about 1degree and about 15 degrees. In another illustrative embodiment, theangel A2 may be between about 3 degrees and about 10 degrees. In afurther illustrative embodiment, the angel A2 may be about 7 degrees. Asseen in FIGS. 6 and 10 , each arm 236 further includes an inner,generally cylindrical edge 256 that tapers outwardly from an inner,generally cylindrical surface 258 of the proximal segment 226.

Referring to FIG. 11 , the inner surface 258 of the proximal segment 226has an inner diameter 259 that may not vary along a first section 262and that may include both the central segment 234 and a portion of thearms 236. The inner diameter 258 may further include a second section264 that includes at least a portion of the arms 236 and which has adiameter 265 that increases along the longitudinal axis 224 from thecentral segment 234 toward the first end 228. The arms 236, as seen inFIG. 11 include helical threading 241 that has minor diameters 266 a-266e and major diameters 268 a-268 e. The minor diameters 266 a-266 e ofthe helical threading 41 may be constant in that the diameters thereofdo not vary along a length of the threading 241 or the minor diameters266 a-266 e may have different or varying diameters. The major diameters268 a-268 e of the helical threading 41 may be constant in that thediameters thereof do not vary along a length of the threading 241 or themajor diameters 268 a-268 e may have different or varying diameters. Inillustrative embodiments and similar to the embodiment of FIGS. 1-5 ,the major diameters 268 a-286 e may increase from a first major diameter268 a closest the central segment 234 toward the first end 228 of theproximal segment 230. In other illustrative embodiments, two or moreconsecutive or non-consecutive major diameters 268 a-268 e may beincreasing between the major diameter 268 a and the major diameter 268 eand/or two or more consecutive or non-consecutive major diameters 268a-268 e may be the same.

Referring again to FIG. 11 , the distal segment 230 includes an innercylindrical surface 280 having an inner diameter 282. The inner diameter282 may be constant or may vary along the longitudinal axis 224. Theinner diameter 282 may be the same as or less than the inner diameter259 of the proximal segment 226. Helical threading 284 may be disposedon an outer surface 286 of all or a portion of the distal segment 230.As seen in FIG. 11 , a minor diameter 288 a-288 e of the helicalthreading 284 may be the same for each thread or may increase along thelongitudinal axis 224 of the implant 220 from the second end 232 towardthe first end 228, as discussed above with respect to the embodiment ofFIGS. 1-5 . In other illustrative embodiments, two or more consecutiveor non-consecutive minor diameters 288 a-288 e may be increasing betweenthe minor diameter 288 a and the minor diameters 288 e and/or two ormore consecutive or non-consecutive minor diameters 288 a-288 e may bethe same.

Major diameters 292 a-292 e of the helical threading 284 may increase indiameter from the major diameter 292 a to the major diameter 292 e orthe major diameters 292 a-292 e may be the same. Still alternatively,two or more consecutive or non-consecutive major diameters 292 a-292 emay be increasing between the major diameters 292 a and the majordiameter 292 e and/or two or more consecutive or non-consecutive majordiameters 292 a-292 e may be the same.

While a particular number of threads are depicted for the threading 241and 284, any number of threads may be present depending on a particularapplication for the implants 20, 220.

Implantation of the implants 20, 220 will now be discussed in detail.Prior to implantation, the proximal interphalanxal (PIP) joint of thepatient is opened using, for example, a dorsal approach. A head of aproximal phalanx 104 of the patient is prepared by reaming untilbleeding bone is reached, for example, using a proximal phalanx reamerand a base of a middle phalanx 100 of the patient is also reamed untilbleeding bone is reached, for example, using a middle phalanx reamer.Once the middle phalanx 400 is reamed, a distal K-wire may be insertedinto a center of the middle phalanx 400. As seen in FIG. 12 , tap 410 ofthe appropriate size 410 is selected for the desired implant size and,using firm axial pressure, the tap 410 is advanced over the distalK-wire into the middle phalanx 100 until a laser line 412 on the tap 410is level with an outer surface 414 of the middle phalanx 400. A proximalK-wire 416 may be inserted into a center of the proximal phalanx 404, asseen in FIG. 13 . In an illustrative embodiment, the K-wire 416 may beintroduced at a 10 degree angle plantar to a medial axis of the proximalphalanx 404. An appropriate drill size may be selected and advanced overthe K-wire 416 into the proximal phalanx 404 until a laser line 420 onthe drill 418 is level with an outer surface 422 of the proximal phalanx404, as seen in FIG. 13 , and the proximal K-wire 416 may be removedafter drilling.

The second end 32, 232 of the distal segment 30, 230 of either implant20, 220 is threaded into the middle phalanx 400 of the patient, as seenin FIG. 14A, using an implantation tool 500, until an increase in torqueindicates firm seating of the implant 20, 220. Additionally, an outeredge of the middle phalanx 400 may be aligned with a laser line 402positioned between the proximal and distal segments 26 or 226, 30 or 230and should be facing dorsally. The laser line 402 is formed of one ormore of a black burn, engraving, one or more dyes, or any other suitablesubstance capable of creating a line, marker, or other indicator. Thelaser line 402 provides guidance to a surgeon or other healthcareprofessional such that the distal segment 30, 230 of the implant 20, 220is threaded into the middle phalanx 400 to an optimal or ideal depth.The laser lines on the tap 410 and the drill 418 additionally preparethe bone for insertion of the implant 20, 220 to an appropriate depth.

The implantation tool 500, as best seen in FIG. 14B, may include agenerally cylindrical body 502, although, the body 502 need not becylindrical. Three arms 504 extend outwardly from a first end 506 of thebody 502. Each of the arms 504 includes a wider based 508 that tapersinto a narrowed tip 510. The arms 504 are sized and shaped to becomplementary to and fit within the channels 40, 240 formed by the arms36, 236 of the implant 20, 220, as seen in FIG. 14A. In illustrativeembodiments, the implantation tool 500 may retain the implant 20, 220 onthe first end 506 by, for example, an interference fit. In otherillustrative embodiments, the implantation tool 500 may fit within theimplant 20, 220, but may not retain the implant 20, 220 on the first end506.

As may be seen in FIG. 14A, an outer diameter of the arms 504 of theimplantation tool 500 is fully within an outer or major diameter of thethreads 68 a-68 e, 268 a-268 e. Each of the arms 504 may also include alaser mark 512 that denote which way the implant arms 36, 236 areoriented. As one skilled in the art will understand, if an implantincludes more than three arms/three recesses, the implantation tool 500may include a similar number of arms.

After the distal segment 30, 230 is implanted within the middle phalanx400 and the distal K-wire 416 is removed, the proximal segment 26, 226of the implant 20, 220 is aligned with a proximal phalanx 404 of thepatient. More specifically, the barbed anchor 38, 238 at the first end28, 228 of the proximal segment 26, 226 is aligned with and insertedinto the pre-drilled hole in the proximal phalanx 404, as seen in FIG.15 . The proximal segment 26, 226 is thereafter pressed into theproximal phalanx 404. Once both the proximal and distal segments 26 or226, 30 or 230 are implanted within the proximal and middle phalanges404, 400, respectively, a typical surgical procedure is used to closethe patient.

Oftentimes, implants, such as implant 20, 220 or any of the implantsdisclosed herein, must be removed and replaced (during, for example, arevision surgical procedure). It can be very difficult to remove thedistal and/or proximal segments 30 or 230, 26 or 226 from the middle andproximal phalanges 400, 404, respectively. The implant 20, 220 may beprovided with features that allow for easier removal of the implant 20,220 from the middle and proximal phalanges 400, 404. More particularly,in illustrative embodiments, the implant 20, 220 may be manufactured ofa polymeric material, for example, ultra-high molecular weightpolyethylene (UHMWPE), polyetheretherketone (PEEK), or any othersuitable polymeric material. The central segment 34, 234 of the implant20, 220 may be cut to sever the proximal and distal segments 26 or 226,30 or 230 from one another. In illustrative embodiments, the centralsegment 34, 234 may be cut at a point 130 adjacent the distal segment30, 230.

In illustrative embodiments, once the implant, for example, the implant20, is severed, a tool 440 that is made of a high-strength material, forexample, stainless steel, having threading 442 may be threaded into thedistal segment 30. In illustrative embodiments, the threading 442 on thetool 440 taps out the inner cylindrical surface 80 of the distal segment30 such that opposing threads are created therein. Once the tool 440 isthreaded a sufficient distance into the distal segment 30, the tool 440may be threaded or pulled in a direction 444 opposite the direction ofthreading to remove the distal segment 30 from the middle phalanx 400.In a similar manner, the tool 440 may be threaded into the proximalsegment 26, for example, such that the threading 442 on the tool 440taps out an inner surface 446 of the central segment 34 and/or theproximal segment 26, thereby creating opposing threads therein. Once thetool 440 is threaded a sufficient distance into the proximal segment 26,the tool 440 may be threaded or pulled in a direction opposite thedirection of threading to remove the proximal segment 26 from theproximal phalanx 404.

In other illustrative embodiments, the implant, for example, the implant220, may include a proximal segment 226 having an internal drive feature450 (see FIG. 9 ) that mates with a tool 452 such that, upon rotation ofthe tool 452, the distal segment 230 may be threaded out of the bore inwhich it was implanted. In the illustrative embodiment, the drivefeature 450 may be comprised of a hexalobe bore formed by thecylindrical inner edge 256 that form semi-cylindrical channels andportions of the central segment 34 that form semi-cylindrical channels.Alternatively or additionally, the drive feature 450 may include anysuitable feature(s) or geometr(ies) configured to accept a tool andallows for rotation of the implant 220 using the tool 452. While sixsemi-cylindrical channels are depicted in FIG. 9 , any suitable numberof semi-cylindrical channels may be utilized.

Any of the implants disclosed herein may be manufactured in differentsizes, for example, for differently-sized phalanges of the same foot orphalanges of persons with differently-sized feet, toes, and/orphalanges. In an illustrative embodiment, three or moredifferently-sized implants may be provided, for example, small, medium,and large implants or small, medium, large, and extra-large implants. Inan illustrative embodiment with small, medium, and large implants, anoverall length of the small implant may be 13 millimeters, a proximallength L1 may be 7 millimeters, and a distal length L2 may be 6millimeters. Similarly, an overall length of the medium implant may be14 millimeters, the proximal length L1 may be 7 millimeters, and thedistal length L2 may be 7 millimeters. Still further, an overall lengthof the large implant may be 15 millimeters, the proximal length L1 maybe 7 millimeters, and the distal length may be 8 millimeters. In otherembodiments, the overall length of one or more implants may be betweenabout 5 millimeters and about 20 millimeters.

Any of the implants disclosed herein may be manufactured of one or moreof metal, ultra-high molecular weight polyethylene (UHMWPE), ceramic,polyetheretherketone (PEEK), or any other suitable material ormaterials.

While the implants disclosed in detail herein are discussed as beingsuitable for treatment and correction of hammertoe, the implantsdisclosed herein may be utilized for treatment and/or correction ofother conditions, for example, other conditions in the foot or handand/or conditions related to other joints.

Any one or more features of any of the implant disclosed herein may beincorporated (alone or in combination) into any of the other implantsdisclosed herein.

While certain illustrative embodiments have been described in detail inthe figures and the foregoing description, such an illustration anddescription is to be considered as exemplary and not restrictive incharacter, it being understood that only illustrative embodiments havebeen shown and described and that all changes and modifications thatcome within the spirit of the disclosure are desired to be protected.There are a plurality of advantages of the present disclosure arisingfrom the various features of the apparatus, systems, and methodsdescribed herein. It will be noted that alternative embodiments of theapparatus, systems, and methods of the present disclosure may notinclude all of the features described yet still benefit from at leastsome of the advantages of such features. Those of ordinary skill in theart may readily devise their own implementations of the apparatus,systems, and methods that incorporate one or more of the features of thepresent disclosure.

1. An orthopedic implantation kit, comprising: an orthopedicimplantation tool including: a body defining a longitudinal axis; threecircumferentially spaced apart tool arms extending from the body, eachof the tool arms including: a first surface extending from the body andwithin a first plane parallel to the longitudinal axis; and a secondsurface distal to and extending distally from the first surface, thesecond surface being within a second plane transverse to thelongitudinal axis, wherein each of the first and the second surfacesextends across a full width of the arm defined within a plane extendingradially from the longitudinal axis; and an orthopedic implant definingrespective recesses configured to receive the three circumferentiallyspaced tool arms of the orthopedic implantation tool, wherein the toolarms are configured for moving and thereby causing implantation of theorthopedic implant when the tool arms are received by the recesses ofthe orthopedic implant.
 2. The orthopedic implantation kit of claim 1,wherein the orthopedic implant includes a laser line configured toindicate alignment of the orthopedic implant with a surface of the bone.3. The orthopedic implantation kit of claim 1, wherein each of the toolarms is inserted between respective sets of two circumferentially spacedapart implant arms of the orthopedic implant when recesses of theorthopedic implant receive the tool arms.
 4. The orthopedic implantationkit of claim 3, wherein each of the tool arms includes a base and a tipthat is attached to and thinner than the base, wherein the respectivesets of two circumferentially spaced apart implant arms of theorthopedic implant each define a semi-cylindrical channel, and whereinthe tip of each implant arm is complementary to each semi-cylindricalchannel and the base is complementary to a surface wider than eachsemi-cylindrical channel.
 5. The orthopedic implantation kit of claim 1,wherein the orthopedic implant extends between a first end and a secondend opposite the first end, wherein the recesses of the orthopedicimplant are positioned at the first end, and wherein the second end isthreaded.
 6. The orthopedic implantation kit of claim 1, wherein each ofthe implant arms includes a third surface within a third plane, thethird plane being transverse to the second plane and the third surfacebeing distal to the second surface, the third surface further extendingfrom the second surface along a full width of the second surface.
 7. Theorthopedic implantation kit of claim 1, wherein the tool arms of theorthopedic implantation tool are configured to rotate the orthopedicimplant when the recesses of the orthopedic implant receive the toolarms of the orthopedic implantation tool.
 8. An orthopedic implantationkit, comprising: an orthopedic implantation tool including: a body;three tool arms extending from the body, wherein each of the tool armsdefines a central plane that extends radially from the center of theimplantation tool, wherein a distal end of each of the tool arms isspaced apart from the distal ends of each of the other tool arms, andwherein each of the tool arms includes a side having a plurality ofsurfaces defining a set of planes, each of the planes of the set ofplanes of the side being parallel to or forming a different angle withrespect to the central plane of the respective tool arm than the otherplanes of the set of planes; and an orthopedic implant definingrespective recesses configured to receive the three tool arms of theorthopedic implantation tool, wherein the tool arms are configured formoving and thereby causing implantation of the orthopedic implant whenthe tool arms are received by the recesses of the orthopedic implant. 9.The orthopedic implantation kit of claim 8, wherein the tool arms of theorthopedic implantation tool are configured to rotate the orthopedicimplant when the recesses of the orthopedic implant receive the toolarms of the orthopedic implantation tool.
 10. The orthopedicimplantation kit of claim 8, wherein each of the tool arms of theimplantation tool is sized and shaped to be a complementary fit within achannel formed between adjacent implant arms on a first end of theimplant.
 11. The orthopedic implantation kit of claim 10, wherein eachof the tool arms of the implantation tool has a base at a proximal endof the tool that tapers in a distal direction to a tip narrower than thebase.
 12. The orthopedic implantation kit of claim 8, wherein each ofthe tool arms includes a first surface extending from the tool bodyalong a plane parallel to a longitudinal axis defined by the tool body,each of the tool arms further including a second surface distal to thefirst surface and extending along a plane parallel to the longitudinalaxis, the first and the second surface spanning a full width of each ofthe respective tool arms.
 13. The orthopedic implantation kit of claim8, wherein each of the tool arms defines a respective tip spanning afull width of the respective tool arm.
 14. An orthopedic implantationkit, comprising: an orthopedic implant extending from a first end to asecond end and including: a central segment; and three circumferentiallyspaced bendable implant arms at the first end extending from the centralsegment and defining a channel between adjacent ones of the implantarms; and an orthopedic implantation tool including: tool arms sized andshaped to complementarily fit into the first end of the implant, whereina surface of each of the tool arms contacts first and second surfaces ofcorresponding ones of the implant arms and each of the tool armscontacts at least two of the implant arms, and wherein the first andsecond surfaces of each of the implant arms define planes extending intransverse directions to each other.
 15. The orthopedic implantation kitof claim 14, wherein the first surface of each of the tool arms definesa plane parallel to a longitudinal axis of the tool arm and the secondsurface of each of the tool arms defines a plane transverse to therespective first surface.
 16. The orthopedic implantation kit of claim14, wherein the orthopedic implant is configured to be implanted into amiddle phalanx.
 17. The orthopedic implantation kit of claim 14, whereinthe first end of the orthopedic implant is configured to be implantedinto a proximal phalanx and the second end of the orthopedic implant isconfigured to be threaded into a middle phalanx.
 18. The orthopedicimplantation kit of claim 14, wherein the second end of the implantincludes an outer surface having a helical threading.
 19. The orthopedicimplantation kit of claim 14, wherein the orthopedic implant includes amarking configured to indicate alignment of the orthopedic implant witha surface of a bone.
 20. The orthopedic implantation kit of claim 14,wherein each of the implant arms includes a barb at the first end of theimplant for anchoring the implant.